Archive for the ‘Providers’ Category

Note:  The provisions discussed below were not included in the final legislation. The White House summary of  new proposed measures to “crack down on waste, fraud and abuse” include a number of provisions from H.R. 3970, the “Medical Rights and Reform Act” sponsored by Representative Mark Kirk (R-IL) and 12 Republican co-sponsors. One of these  [...]


The Commonwealth Fund has developed interactive tables for side-by-side comparisons of the system reforms and insurance coverage provisions in the two health reform bills.  After clicking on the link, check the box for the House bill or the Senate bill (both if you want to see a comparison), then click on the subject matter that [...]


Under health reform, federal law would finally require private health insurance companies to pay hospitals that treat real medical emergencies for that care.


The law firm of Mintz Levin has published a nice summary of provisions in the House and Senate bills intended to combat fraud and abuse.   See it here.


To the extent that searching for particular section numbers in the Senate Democrats’ “Managers’ Amendment” can justify such a conclusion, I have determined that none of the materials in my recent posts relating to nursing homes would be affected by the new version of the bill.


Effective Compliance and Ethics Programs Most healthcare providers are not required by current law to have broad-based compliance and ethics programs – although they are strongly encouraged. Under Healthcare Reform, the HHS Secretary in consultation with the Office of Inspector General (OIG ) must adopt regulations requiring nursing homes (skilled nursing facilities (SNFs) and “nursing [...]


Consumer website “Nursing Home Compare” is a website operated by the Centers for Medicare and Medicaid Services (CMS), the federal agency that runs the Medicare and Medicaid programs, in order to provide information obtained through the government’s regular oversight of nursing home operations and quality to consumers. Under the new Health Reform statute, there will [...]


Current law provides that the federal government can impose civil money penalties on a nursing home found to have violated various quality, safety or operational standards.  The House bill would replace the existing penalties of up to $10,000 per day with a sliding scale for per-day violations, as follows – Where there is a finding [...]


CMS has for a number of years operated a pilot program whereby 7 States (AK, ID, IL, MI, NV, MN, WI) conducted comprehensive background checks on potential direct-patient-access employees of long-term care facilities.  Both the House and Senate bills would extend this program “nationwide” – with the proviso that for it to be applicable to [...]


The House bill contains a number of changes to the way skilled nursing facilities (SNFs) are reimbursed by Medicare, most of which do not appear in the Senate bill. If you aren’t involved in operating a skilled nursing facility, give this post a miss.  It’s pretty technical. The changes involve the following topics.  You’ll find [...]



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